HomeMy WebLinkAboutConsent Form CITY OF MAPLE RIDGE
PLANNING DEPARTMENT
CONSENT FORM
Complete the appropriate statement:
1. ______________________________________________
(Owner(s) Please Print)
Solemnly declare that I am the owner as defined in the Local Government Act of the
real property described as:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
and I am registered as such in the Land Title Office, New Westminster, BC.
2. I ___________________________________________________________
(Agent, Please print)
Solemnly declare that I am the authorized agent of the registered owner(s) of the real
property described in paragraph 1 above.
It is understood that until the City is advised in writing that the above named agent no longer
acts on my behalf in the premises, the Corporation shall deal exclusively with that agent with
respect to all matters pertaining to the application and is under no obligation to
communicate with me or any other person other than the agent with regard to the
application.
Agent ___________________________ Owner _________________________________
(Print) (Sign) (Print) (Sign)
Owner _________________________________
(Print) (Sign)
Date _____________________________
Agent Info:
Address & Postal Code
______________________________________________________________________________
Telephone: ____________________Cell: ____________________Fax: ____________________
Email: _________________________________
Date _________________________ Date Received _________________________